Individual
ALCIDES CAMPILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6249 W 15TH CT, HIALEAH, FL 33012-6205
(786) 374-6540
Mailing address
6249 W 15TH CT, HIALEAH, FL 33012-6205
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
9415128
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F07180821
FNP
FL
Enumeration date
08/22/2018
Last updated
08/22/2018
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